Is My Child Autistic? An Early Red-Flags Checklist

If you have typed “is my child autistic” into your phone at midnight, here is the honest answer first: no checklist can tell you, but it can tell you whether it is time to ask someone. The pattern that matters is a cluster of social-communication signs — name response, eye contact, pointing, gestures, shared play — appearing together and staying put over weeks, not one odd habit on one tiring day.

Below is that checklist, set out age by age, with a plain explanation of how to read your own answers, what is not a sign, and what a first appointment in Multan actually involves. You are not overreacting for wanting to understand your child. This is not a diagnosis — only a trained professional can assess autism — but it is an honest place to begin.

Is my child autistic? The short answer

No online checklist can tell you whether your child is autistic. Only a trained professional can, after watching your child and taking a full developmental history. What a checklist can do is show you whether several social-communication signs are appearing together. A cluster of signs that persists over weeks is the signal worth acting on.

If you would like to see how we bring speech, behaviour and learning support into one plan for a child who does turn out to be autistic, that is our autism support program in Multan. But read the checklist first — many of the families who come to us leave reassured.

What are the early signs of autism, by age?

Autism shows up differently at different ages, because what a child is expected to be doing changes. The checkpoints below are the ones we watch most closely. Read the age band your child has already passed, not the one they are in the middle of.

By 9–12 months

• Doesn’t respond to their name
• Little eye contact or shared smiling
• Doesn’t babble back or copy sounds
• Doesn’t wave, point or reach to be picked up

This is the softest age band, and the one where signs are easiest to misread. If your worry starts here, read our gentler, longer guide to the early signs of autism in babies under 12 months — it explains why nothing at this age is ever proof.

By 18 months

• Doesn’t point to show you something interesting (“look at that!”)
• Few or no words, and not copying words
• Little pretend play — no feeding the doll, no driving the car
• Prefers to play alone, “in their own world”

Pointing is the one we watch hardest. There is a difference between pointing to get (reaching towards the biscuit tin) and pointing to share (“look, a bird!”). Pointing to share is the skill most often missing early.

By 2–3 years

• Very limited speech, or lost words they once used
• Doesn’t follow simple instructions
• Little interest in other children
• Lines things up, spins objects, or fixates on parts of toys
• Repetitive movements — hand-flapping, rocking, toe-walking
• Very upset by changes in routine, or by sounds, textures or lights

By 3–4 years and older

Children whose early speech came on time are often noticed later, once they are in a group. At this age the NHS describes signs such as:

• Talking at people rather than having a back-and-forth conversation
• Repeating words and phrases they have heard elsewhere
• A flat or unusual tone of voice
• Finding group play hard, or showing little interest in other children
• Intense, narrow interests they talk about at length
• Strong reactions to noise, light, clothing textures, or a very restricted diet

I ticked a few boxes — does that mean autism?

One tick is usually nothing. Plenty of typically developing children line toys up, flap when excited, or ignore their name when a cartoon is on. What matters is a cluster: several signs together, especially in social communication — name response, eye contact, pointing, gestures, shared attention — that stay steady across weeks, places and people.

So before you count anything, ask one question: when my child wants something, how do they let me know? A child who pulls your hand, points, catches your eye or brings you the object is showing strong social communication, whatever their vocabulary is doing. A child who climbs up and manages alone, or leads you by the wrist without ever looking at your face, is the one worth having looked at.

That distinction is also the clearest line between autism and a plain language delay — we walk through it properly in speech delay vs autism.

What is not a sign of autism?

Half of what frightens parents online turns out to be ordinary. These, on their own, do not indicate autism:

• Being shy or slow to warm up. Temperament is real, and quiet children are not autistic children.
• Growing up with two or three languages. Urdu, Saraiki, Punjabi and English together do not cause autism and do not cause speech delay. Count your child’s words across all their languages, not just one.
• Toe-walking, spinning or flapping by itself, with warm eye contact and shared play alongside it.
• Screen time, vaccines, or anything a parent did or did not do. We unpick the common ones in what causes autism: myths and facts.

And one thing that is very often mistaken for autism: hearing. A child who does not turn to their name is far more often a child who cannot hear you clearly. Fluid behind the eardrum after repeated colds is common, easy to miss, and usually treatable. A hearing check is one of the cheapest and kindest first steps you can take.

Do I need a diagnosis before therapy can start?

No. Therapy works on what a child actually needs — talking, understanding, play, coping with change — and none of that waits for paperwork. You do not need a diagnosis, a referral or a hospital letter to be seen at our centre in Multan. Support can begin on the strength of an assessment alone.

A developmental assessment and a formal medical diagnosis are two different things, and mixing them up costs families months. An assessment describes what your child can and cannot do yet, and what would help. A formal diagnosis of autism comes from a developmental paediatrician or a psychiatrist. If a formal diagnosis is what your child genuinely needs — for a school place, for official paperwork, or because the picture is unclear — we say so and tell you who to see.

What happens at an autism assessment in Multan?

It is a play session, not a test. A developmental assessment at Inclusive Developmental and Therapy Center is led by Mahnoor Baloch, a Speech & Language Therapist, and looks at six areas at once: speech and language, movement, play and social skills, attention and behaviour, early learning, and how your child copes with senses and daily routines. We see children from twelve months to sixteen years, in Urdu or English. The first consultation is free.

What we are watching for is subtler than the checklist above. How does your child ask for something they cannot reach? Do they check your face when something surprising happens? What do they do when the routine we have just set up is broken on purpose? Those small moments tell us more than any single missed milestone.

What usually shifts first, once support starts, is not sentences — it is requesting. A child who learns to point, hand over a picture or pull you to what they want has just discovered that communication works, and frustration and meltdowns often ease before a single new word arrives. Speech, where it comes, tends to follow that. Where behaviour is the bigger barrier, structured behavioural work has a role too — here is a plain explanation of what ABA therapy actually is.

What can I do at home tomorrow morning?

You do not need equipment, an app, or a diagnosis to start. You need to get down to eye level and slow everything down.

• Follow their lead. Whatever they are staring at, join them there and name it. Their interest, not yours.
• Leave a gap. Ask, then wait five full seconds. Most of us fill the silence before a child gets a chance to.
• Make them ask. Put a favourite thing in sight but out of reach. Accept a look, a reach or a sound as an answer — then give it straight away.
• Say it once, simply. One or two words, matched to what is happening: “juice”, “open box”, “Ammi’s turn”.
• Keep short notes. Dates, what you saw, how often. Video on your phone is even better — thirty seconds of ordinary play tells us more than an hour of description.

Parents here often describe it in the same words: mera bacha bolta nahi, or apni dunya mein rehta hai. If آٹزم is the word going round your head, it is worth saying out loud to someone who assesses children for a living — in Urdu or in English, whichever you think in.

When should you stop waiting?

Stop waiting and ask for an assessment if a skill has been lost, if more than one area worries you, or if the same worry has been in your head for longer than about three months. Losing words, eye contact or play that a child already had is the one sign we never ask a family to watch for a while longer.

“Wait and see” is reasonable only when a child is doing well everywhere else and is slightly behind in one area — and even then, put a date on the waiting rather than leaving it open. Nobody can pick out in advance which children will catch up on their own; that is only ever clear afterwards.

Your next step in Multan

If this checklist raised something, the next step is small: a conversation, then a play-based assessment if it is warranted. You will leave with either reassurance or a plan — both are better than another midnight search. You can read more about autism and how we support children, or call or WhatsApp us to ask a question first. There is no pressure, and no diagnosis required to talk to us.